Sustainability: Mental Health and Wellbeing

ACT training for medical/healthcare Students

What is ACT ?
Acceptance and Commitment Therapy (ACT) is a behavioural approach grounded in relational frame theory. It emphasises acceptance of internal experiences, cognitive defusion (distancing from thoughts), values clarification, and committed action. Rather than attempting to control, block or eliminate distressing thoughts and emotions, ACT promotes psychological flexibility—the capacity to act in accordance with one’s values despite the presence of difficult internal states. The aim is to help individuals become more flexible in how they think and respond, so they can handle challenges more effectively, and take actions that reflect what matters to them and are aligned with their core values.

Why ACT skills matter to Medical Students
For medical students who frequently encounter high cognitive and emotional demands, ACT offers evidence-based strategies to navigate distressing thoughts and emotions without becoming entangled in them. Developing psychological flexibility can reduce the impact of anxiety, self-criticism, and performance-related stress by promoting adaptive responses to internal challenges. Acceptance-based techniques support sustainable personal development, and are especially useful for preventing burnout and building long-term resilience in high-pressure environments.

Case study
All students registered with My Medic are invited to take part in the Acceptance and Commitment Therapy (ACT) skills course.

The course consists of four modules designed to introduce the six core principles ACT. The modules are delivered online in small groups with two tutors, one of whom is an Occupational Psychologist. Each module is supported by a workbook, helping students record their reflections of the module content and complete individual exercises designed to reinforce the skills, in a personal way.

While the course is not intended to provide therapy, it offers practical ACT-based tools that students can use independently to build a sustainable skillset for managing cognitive and emotional challenges, particularly within academic and clinical settings.

Course Delivery:

• Four modules, delivered over four weeks, on dates chosen to avoid academic assessments.
• Presented online, allowing access for students who are on placement across Wales and across year groups.
• Group sizes are kept small (typically 3–7 students) to encourage discussion and create a supportive learning environment.

Evaluation and Feedback: Student who enrol on the course are also invited to participate an evaluation study which uses four validated clinical survey tools to assess the impact of the training programme. Pre- and post-course data are collected to evaluate outcomes and guide future improvements, whilst a focus group provides space for shared reflection. A follow-up survey at 12 weeks helps assess longer-term effects.

Participation in both the course and the study is entirely voluntary, with students free to withdraw at any time.

Student Feedback: Feedback has been positive. Students report increased awareness of unhelpful thought patterns and positive experiences of using ACT skills to manage difficult situations. All participants would recommend the course to their peers.

This case study was shared by Liz Forty, Reader in Medical Education. 

For further information about the ACT training programme or the results of the evaluation please contact MyMedicLDU@cardiff.ac.uk

Background and Aim

The aim of the Health Passport is to enable medical students to have conversations with key individuals in the University and the NHS in relation to their health needs/disability and adjustments particularly within the context of their learning needs.

Starting such conversations can be difficult for students and the Health Passport is a tool designed to facilitate these conversations. The Health passport provides students with an up to date record of their adjustments and any support needs they may have. The passport reduces the need for students to repeat details of their health condition/disability and how it can affect them in the learning environment.

What is the Health Passport?

The Health Passport is designed for students who have a long-term health condition that could, at some time during their studies, impact on their ability to learn and study effectively.  The focus is to empower students to help them manage their own condition and share information with those who may need to know about it. Students can take and discuss their Health Passport with whoever they so choose, for example their UG teams, educational supervisors, tutors/assessors, lecturers, clinical skills tutors, CBL facilitators, year directors.

The Health Passport has been designed and is supported by those with long-term conditions, students, educators, the General Medical Council and the Medical Schools Council. It aims to remove or reduce obstacles and enable more effective learning for our students.

The purpose of the Health Passport is to:

• describe the student’s condition and its potential impact on their learning.
• detail reasonable adjustments that have been jointly agreed, either short term or long term, which will allow the student to learn effectively.
• describe what tutors/educators should do if the students condition flares/is exacerbated/not controlled.
• detail other people who may need to be contacted if their condition changes.

How we introduced the Health Passport at Cardiff Medical School

In 2024/25, we introduced an electronic Health Passport that is available on Pebble Pad for all MBBCh students who have Reasonable Adjustments in place through the Cardiff University Student Disability Service (SDS).

All students who have Reasonable Adjustments are provided with information about the Health Passport and how they can complete and access their Health Passport.

The Health Passport is jointly created and agreed between the student and their My Medic Learning Development Unit advisor. The advisor and student meet for a confidential and informed discussion. The Health Passport contains only information that the student wishes to be included, and it is up to the student who they share the Health Passport with. Students can update their Health Passport as needed with the support of their My Medic Advisor. The student can share their health passport on Pebble Pad either by physically showing a staff member their health passport on their device or by sending a copy of the electronic form via pebble pad/email to the staff member (e.g. University and/or NHS staff).

Information about a student’s reasonable adjustments continues to be shared with relevant university and placement teams through the usual process. The Health Passport is an additional avenue through which students can share this information. The Health Passport also enables the student to provide any additional contextual information that might be helpful for staff supporting the student to be aware of.

Student feedback has been positive. Students initially weren’t sure about how they shared there health passport with staff and so we have provided additional communication about this aspect of the process to help students feels more confident in sharing their health passport.

This case study was shared by Liz Forty, Reader in Medical Education. 

If you have any questions or would like further information about the Health Passport and it’s evaluation, please contact HealthPassportMedic@cardiff.ac.uk

Content:

Rates of mental health issues in students continue to increase and significant numbers of young people in the UK die by suicide. This training starts from the view that suicide is not inevitable and can, with timely intervention, be prevented.

‘Keep Safe: Suicide Awareness and Safety Skills’ is a one-off workshop that aims to educate first year medical students in the issues that may lead to, and the effects of, suicide.  It also equips them with practical approaches to supporting each other and raising concerns.  This does not form part of their clinical training but is intended to provide strategies and skills that will be helpful in their student lives.

They are given guidance on noticing signs of mental ill health in themselves and their peers, and basic skills for helping somebody who might be experiencing suicidal thoughts, from initiating a conversation with that person, to asking directly about possible suicidal thinking, to linking them with appropriate university and medical support.

The training covers the following topics:

• Myths and facts around suicide
• Emotional resilience as a defence against mental health issues
• Reasons a student may become suicidal
• Barriers that stop a student getting the help they need
• Fears that stop people helping someone at risk
• How to carry out the LOOK - LISTEN - LINK model
• Identifying the signs that warn that someone may be at risk and the severity of that risk
• Active listening skills
• Maintaining self-care when supporting others

Delivery and Pedagogy:

The training is taken from an evidence-based programme originally developed by PIPS, a Suicide Prevention charity based in Ireland, and delivered to staff and students by the Centre for Student Life at Cardiff University.  We tailored this training for a medical student cohort and it has been included as a core component of the year 1 curriculum since 2022/23. The training incorporates group activities and quizzes, videos, statistics and clear instructional information over the course of a two-hour, in person, training workshop. All workshops are delivered by two instructors, ensuring support is available for students as needed. Students could choose not to attend the training due to personal reasons. Over 90% of students attended the training.

This case study was shared by Liz Forty, Reader in Medical Education. 

For Further information about this case study, please contact MyMedicLDU@cardiff.ac.uk